JMIR Publications

ABSTRACT

Background:

Opioid medications are important in pain management. Despite this, many patients progress to unsafe medication use. With few personalized and accessible behavioral treatment options to reduce opioid-related harm, new and innovative approaches are urgently needed to fill this gap. Co-design methods offers an opportunity to put patient partners at the centre of the solution.

Objective:

This study involved the first phase of co-design of a digital brief intervention (BI) to reduce opioid-related harm – investigating the lived experience of chronic non-cancer pain (CNCP) in treatment-seeking patients with a particular focus on opioid therapy experiences.

Methods:

Eligible patients were aged 18-70 years, with CNCP at clinically significant intensity (> 4/10). Purposive sampling was used to engage patients on public hospital wait lists via mail, or the treating medical specialist. Participants (N = 18; 10 women; Mage = 49.5+/- SD years) completed semi-structured phone interviews. Interviews were transcribed verbatim, thematically analysed using grounded theory and member checked by patients.

Results:

Eight overarching themes were found (mostleast prominent): Limited treatment collaboration and partnership; Limited biopsychosocial understanding of pain; Continued opioid use when benefits don’t outweigh harms; Trial and error approach to opioid use; Cycles of hopefulness and hopelessness; Diagnostic uncertainty; Significant negative impacts tied to loss; and Complexity of pain and opioid journeys.

Conclusions:

This study advances progress in co-design of digital BIs by actively engaging patient partners in their lived experiences. Key recommendations for consideration in the co-design process should guide personalized solutions to address the complex care needs of patients with CNCP.